Pemetrexed Maintenance Therapy Following Bevacizumab-Containing First-Line Chemotherapy in Advanced Malignant Pleural Mesothelioma: A Case Report and Literatures Review

Medicine (Baltimore). 2016 Apr;95(14):e3351. doi: 10.1097/MD.0000000000003351.

Abstract

Malignant pleural mesothelioma (MPM) is a lethal disease with poor prognosis. The combination of cisplatin and pemetrexed has been confirmed as the standard of care for nonoperable MPM. Data have shown that the adoption of pemetrexed maintenance therapy (PMT) following first-line treatment appears extremely promising.We describe a 57-year-old man diagnosed as advanced MPM. We treated this patient with PMT after first-line cisplatin-based bevacizumab-containing chemotherapy and residual tumor disappeared after 6 course of PMT. A perfect response and a long progression-free survival (PFS) were reached with tumor mass disappearing and 14 months duration of PFS.This case suggests that adding bevacizumab to standard first-line chemotherapy is feasible and that PMT could be promising and useful for treating advanced MPM. We further entail a review of the literature on the first-line treatment, continuation maintenance therapy, switch maintenance therapy, and second-line treatment of patients with advanced MPM.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Bevacizumab / therapeutic use*
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Maintenance Chemotherapy*
  • Male
  • Mesothelioma / drug therapy*
  • Mesothelioma / pathology
  • Mesothelioma, Malignant
  • Middle Aged
  • Neoplasm Staging
  • Pemetrexed / therapeutic use*
  • Pleural Neoplasms / drug therapy*
  • Pleural Neoplasms / pathology

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Pemetrexed
  • Bevacizumab